Major hemorrhagic injuries in non-military situations consist primarily of traumatic injuries and major blood vessel (i.e. vascular) injuries. Although all of these injuries or problems are not exactly the same as military casualties, there are major commonalities between these population groups that allow the results of the military studies to be applicable to these civilian populations. Retrospective and case-control trials in non-military trauma and in ruptured abdominal aortic aneurysms (AAA) offer indirect evidence to support a different plasma transfusion practice that is more akin to the military recommendations. Computer simulations to model massive blood transfusion scenarios also gives credence to the premise that traditional transfusion practice is incorrect for actively hemorrhaging patients and advocates the earlier use of plasma.